Should You Cut Back on Salt?

It’s not just chips that are loaded with the stuff — so are dietary mainstays like bread. The average American gets about 3.4 grams of sodium every day, far more than the upper limit of 2.3 grams recommended by the USDA or the 1.5 grams recommended by the American Heart Association. The worry: Too much salt could raise blood pressure, a major step toward heart disease. The Institute of Medicine estimates that reducing sodium intake nationwide could prevent 100,000 deaths every year.

The Headlines Now?
It’s time to get tough.

The New York City health department recently kicked off a national effort to cut the amount of salt in packaged and restaurant food by 25 percent over five years. Eighty percent of the salt in the average person’s diet comes from those sources, not from the saltshaker.

But Wait!
The benefits of salt reduction are surprisingly murky.

At least 13 studies have tried to tease out what happens to people who choose to eat salty or not-so-salty food — and the results have pointed in every conceivable direction, epidemiologist Michael Alderman, MD, pointed out in an editorial in the Journal of the American Medical Association. Some studies suggest that cutting salt protects the heart; others suggest that zealous salt reduction can actually increase heart problems. What’s needed, Dr. Alderman says, is a randomized, controlled trial, in which people are put on different diets and followed for years. It’s the only way to get a reliable answer, but it’s never been done.

So What Should You Do?
Go easy on processed foods and eat more produce. Those changes will improve your diet in a variety of ways and cut the amount of sodium you consume. If your blood pressure is high, work with your doctor to control it with drugs and lifestyle changes. If your blood pressure is healthy? Some doctors will squawk, but at this point, there’s no convincing reason for you to count every grain.